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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why is pupil size,speech and vital signs are observed after head trauma?

Mr. Gutteman, a 70-year old male was brought into the ER in a comatose state and has yet to come out of it. it is obvious that he suffered severe head trauma- his scalp was badly lacerated and he has an impacted skull fracture. his initial lab tests (blood and urine) were within normal limits. his fracture was repaired and the following orders(and others) were given:

check every hour and record; spontaneous behavior, level of responsiveness to stimulation, movements, pupil size and reaction to light, speech, and vital signs.
turn patient every 4 hours and maintain meticulous skin care and dryness.

1. explain the rationale behind these orders.
Tue, 9 Aug 2016
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General & Family Physician 's  Response
Hello

The checking of pupil size, stimulation response, behavior, speech, and vital signs are all an assessment of his neurological condition and to see if there is an expanding hematoma--bleeding in the brain--occurring.

The turning in bed from time to time is to prevent decubitus--pressure--ulcers in the skin
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General & Family Physician Dr. Ralph Chambers's  Response
Hello
These are neuro function tests and they check for increasing intracranial pressure as one would see with a brain bleed,

The turning in bed and the skin care is to prevent decubitus ulcers
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Neurologist Dr. HITESH KUMAR's  Response
After head trauma, there can be contusions and cerebral edema which can lead to herniation of brain (which can be life threatening condition). Pupillary dilatation is early sign of infratentorial herniation when uncus presses over 3rd nerve which leads to dilation of pupil.
spontaneous behaviour, response to stimulation is indicative of cerebral function.
So these all sign help the doctor to analyse patients clinical state.
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Why is pupil size,speech and vital signs are observed after head trauma?

Hello The checking of pupil size, stimulation response, behavior, speech, and vital signs are all an assessment of his neurological condition and to see if there is an expanding hematoma--bleeding in the brain--occurring. The turning in bed from time to time is to prevent decubitus--pressure--ulcers in the skin